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March 12, 2014
Pediatrician Group Calls Drugstore Clinics “Inappropriate” for Children’s Care
Atlanta—Despite surveys suggesting that parents appreciate the convenience of retail clinics in drugstores even if their children have established relationships with pediatricians, the American Academy of Pediatrics again came out against use of the healthcare facilities. Retail-based clinics (RBCs), according to an AAP policy statement, are “an inappropriate source of primary care for pediatric patients, as they fragment medical care and are detrimental to the medical home concept of longitudinal and coordinated care.” The statement, published recently in the journal Pediatrics, updated an original 2006 American Academy of Pediatrics position. At that point, according to the recent release, the pediatrics group “flatly opposed” these sites as appropriate for pediatric care, discussing the shift in RBC focus and comparing attributes of RBCs with those of the pediatric medical home. A study published last July in JAMA Pediatrics, however, found that convenience is what influences parents to bring their ill children to retail clinics, usually located in drugstores and staffed by nonpediatric nurse practitioners and physician assistants. The in-store clinics generally care for patients 18 months and older with minor illnesses such as ear and throat infections. That study, conducted by researchers from the Washington University School of Medicine in St. Louis, was based on a survey completed by 1,484 parents—a 91.9% response rate—who use 19 pediatric practices in the Midwest. According to survey results, 344 parents, 23.2%, had used RCs for their children, with 74% reporting that they had first considered going to their pediatrician. They said they instead chose an RC because: • The retail clinic had more convenient hours, 36.6%; • No office appointment was available at the pediatrician’s office, 25.2%; • They did not want to bother their pediatrician after hours,15.4%, or; • They thought the problem was not serious enough for a pediatrician visit, 13%. The most common reasons reported for the retail clinic visits were acute upper respiratory tract illnesses. Instead of decrying the use of the clinics, authors of that study suggested that pediatricians seek “to optimize communication with the RCs themselves, as well as with their patients regarding appropriate management of acute minor illnesses and the role of RCs. They also will need to directly address parents’ need for convenient access to care.” A statement from the Convenient Care Association called retail clinics “a more convenient option for parents with sick children rather than the alternative, which is often waiting for an appointment while the child is sick or spending hours in a high-cost emergency room for a minor pediatric complaint.” The statement from Tine Hansen-Turton, JD, the association’s executive director, noted that, “Retail clinics work closely with local physicians and pediatricians. They all use electronic health records (EHR) and actively encourage the sharing of visit records with patients' family physicians and pediatricians in order to facilitate continuity of care.” |
U.S. Pharmacist Social Connect
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